Posted 01 May 2020 - 07:15

Nurses, along with other care colleagues, have been described during the COVID-19 pandemic as heroes and saviours, as they provide care in this crisis response environment. Some have died as a consequence of providing this care, possibly because they had inadequate personal protective equipment (PPE).

Nurses have spoken openly about their concerns, citing the danger to patients who may become infected as well as to themselves and their families, and have considered refusing to provide care unless adequate PPE is available.

‘The pressures of caring for patients… without the certainty of a safe working environment, is causing considerable distress’

What is clear is that the pressures of caring for patients with this new and previously unknown virus, in the context of a health emergency without the certainty of a safe working environment, is causing considerable distress and, for some, physical and emotional ill health (Maben and Bridges 2020).

Providing leadership and adapting to evolving situations

Concerns are also being raised about the potential silence and low profile of nursing leaders and their contribution to managing the many challenges of this health emergency (Daly et al 2020).

This recognition needs to be for their success in challenging the status quo and for their compassionate application of nursing science (Daly et al 2020).

Watch: Effective Team Working during the COVID-19 crisis

Assessing whether a crisis has or has not been well-led and managed by members of the healthcare team and our political leaders can be judged objectively only after the event and when a new normal way of working has been established.

Often the narrative of how well people respond to such crises is subjective, with commentators making statements about great or woeful leadership, about heroes and culprits, angels and saviours. This often leads to a ‘blame game’ in the pursuit of accountability (Boin et al 2013), and these unhelpful sentiments and unobjective assessments can hide the effective leadership of the many players, including nurses.

‘The ability to lead effectively rests on a leader being agile, adaptable and able to make sense of the events to others’

It is yet to be determined whether the COVID-19 pandemic has been a crisis or a disaster, but preventing an emergency or crisis from becoming a disaster is a key objective of a crisis leader and manager. Leadership and management of crises can come from those who have never held these positions (Boin et al 2013).

Courage to challenge the status quo

The ability to lead effectively rests on a leader being agile, adaptable and able to make sense of, and give meaning to, the events to others. It is possible that those nurses who have raised concerns about their working environment are demonstrating the courage to challenge the status quo.

But our concern is that future judgements about the leadership response will be too influenced by sentiment and subjective emotions.

By using an appropriate crisis management framework, such as the one proposed by Boin et al (2013), to assess retrospectively the effectiveness of a crisis leadership response, we can hope that a constructive evidence-based narrative will enable claims of leadership limitations or greatness to be balanced and appropriately acknowledged.